Billing Operations Manager, 04/2015 - 08/2017
Alto Pharmacy – Las Vegas, NV, Accurately entered procedure codes, diagnosis codes and patient information into billing software. Acted as a liaison between the business department, billers and third party payers in resolving billing and reimbursement accuracy. Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.
Appropriately and correctly identified errors and re-filed denied/rejected claims as they were received from the Patient Account Representative.
Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses. Thoroughly reviewed remittance codes from EOBS/AR's.
Ensured timely and accurate charge submission through electronic charge capture, including the billing and account receivables (BAR) system and clearing house. Performed quality control of the data entry system to verify that claims and payments were posted correctly.
Billed all lab claims with attached lab slips. Performed full-cycle medical billing in a fast-paced medical billing company. Oversaw 50+ team members as Billing Manager with the day to day Billing Operations including Charge Entry, Rejections, Resubmissions, AR Followup, and Payment Posting.